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Perioperative laryngospasm management in paediatrics: a high-fidelity simulation study
Daphné Michelet1,2, Jennifer Truchot1,3, Marie-Aude Piot1,4
1Ilumens Simulation Department, University Paris Descartes, Paris, France.
BMJ Simulation & Technology Enhanced Learning
|May 6, 2022
Summary
A simple algorithm significantly improved trainee anaesthetists' and nurse anaesthetists' management of simulated laryngospasm. This enhanced both technical and non-technical skills, crucial for handling this life-threatening event in paediatric anaesthesia.
Area of Science:
- Medical Education
- Anaesthesiology
- Paediatric Critical Care
Background:
- Paediatric anaesthesia training is specialized and often lacks comprehensive curriculum coverage for critical events.
- Laryngospasm is a stressful, potentially life-threatening emergency requiring immediate and skilled management.
Purpose of the Study:
- To evaluate the impact of a simple algorithm on the management of laryngospasm by trainee anaesthetists and nurse anaesthetists.
- To assess improvements in both technical and non-technical skills during simulated paediatric anaesthesia emergencies.
Main Methods:
- Randomized controlled trial involving 72 participants (trainee anaesthetists and nurse anaesthetists).
- Participants were assigned to either receive a simple laryngospasm management algorithm pre-simulation (Group A) or standard curriculum training (Group C).
- High-fidelity simulation was used to assess management skills, with primary endpoint being a technical skills score and secondary endpoints including Anaesthetists' Non-Technical Skills (ANTS) score.
Main Results:
- Group A demonstrated significantly higher technical skills scores (8.5) compared to Group C (5) (p<0.0001).
- Non-technical skills, assessed by ANTS score, were also significantly better in Group A (12) versus Group C (8) (p<0.0001).
- A strong correlation was observed between technical and non-technical skills in the algorithm group.
Conclusions:
- A simple algorithm effectively enhances both technical proficiency and non-technical skills in managing simulated laryngospasm.
- This approach offers a valuable adjunct to traditional paediatric anaesthesia training for critical event management.
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